MILESTONE REVIEWS
Understanding Milestone Reviews
The Next Accreditation System is the ACGME’s process put in place to ensure the quality and
safety of the allopathic residency learning environment and to make sure residents are
competent when they complete their training.
There are two parts to the Next Accreditation System:
1. Safe and Effective Learning Environments and
2. Educational Outcomes
The ACGME will monitor the Educational Outcomes through semi-annual reviews and Milestone
Reviews. See the documentation for Portfolio Reviews for more information about the semiannual reviews.
Milestone Reviews are to be conducted on each resident every six months by the Clinical
Competency Committee (CCC). The Next Accreditation System specifies that programs should
form a Clinical Competency Committee who will meet every six months to review each
resident’s performance and rate their level of competency.
Sample Milestone Review
Competency
Subcompetency
Reported Score
Milestone
Comments
Results from
Evaluations
Complete a Milestone Review
Go to Portfolio > Milestones. Members of the CCC can use the Portfolio module to view and
complete the Milestone Reviews for each active resident. Milestone Reviews are created
automatically in the software for any resident or fellow who has a Training Record in their
Personnel file. The Milestone Reviews will cover each six months of training for each resident.
Your specialty’s milestones will be automatically loaded into your Reviews.
Select a resident and the six month period that you want to complete.
NOTE: If a Milestone Review
has been completed on this
resident in the past, you will
receive a pop-up screen
asking if you want to import
the scores from the previous
Milestone Review. Select
either Yes Import Scores or
No Thanks.
Sample
Complete the Milestone Review
1. Review the milestones under each sub-competency and consider past resident
performance.
2. Select one of the nine radio buttons below the grid to indicate the resident’s level of
competency.
a. If a radio button is selected below a level, it means the resident is competent is
all milestones in that level
b. If a radio button is selected midway between Level 2 and Level 3, as shown above,
it means that the resident has attained competency in all of the milestones in
Level 2 and some of the milestones in Level 3
c. If one of the milestones is an area of concern, click on that milestone and it will
be highlighted in yellow showing that the resident has not yet attained
competency for that particular milestone
d. The resident’s Score appears to the right (on top of the grid)
3. Comments:
a. Click the icon of a single sheet of paper to add comments for that subcompetency
b. Click the icon of the double sheets of paper to view comments about this resident
on this subcompetency from previous Milestone Reviews
4. Click Review Feedback from Evaluation Responses to access results from evaluations
that have been completed about the resident. This evaluation feedback can be used by
the CCC as one of the indicators about the resident’s progress. (See the section below
for more details about these evaluation responses.)
5. When the Milestone Review is complete, click Mark Complete at the top
or bottom of the review form.
a. Before marking your Review as complete, the Milestone Review
will be in draft form. Changes can be made to the Review form
by the CCC while in draft, but the results will not appear in any
reports.
b. If changes need to be made after the Milestone Review has been
marked as complete, click Set as Draft, and make the necessary
edits. Be sure to click Mark Complete again when finished making your edits, so
that the results will appear in reports.
Other Options on the Milestone Review Form:
a) Click the Printer icon to print the document
b) Click the PDF icon to save the document to PDF format
c) Click Exit Form to return to the Manage Milestones page
d) Click the Index tab on the left side of the screen to easily move
to another subcompetency
e) Click Comments, under the resident’s photo or at the bottom
of the page, to add general comments about the resident
f) Click Attach Files to attach documents
g) Click Import Scores to import the scores from the last
Milestone Review form. (This link may not be available if no
previous scores have been entered or if the scores have already
been imported.)
h) Click Summarize to collapse the subcompetency grids.
This allows the coordinator to easily view just the scores
given for each resident when entering them into the ACGME
site. Click Details to expand the grids back to the normal view.
Feedback from Evaluations
A summary of the evaluation feedback about a resident can be viewed by the Clinical
Competency Committee when the committee is completing a resident’s Milestone Review. This
evaluation feedback is grouped into Direct Evaluation Responses and Indirect Evaluation
Reponses based on how the questionnaires are configured in the Evaluations module. These are
explained in more detail below.
To obtain the evaluation results:
- Under any of the
Subcompetencies, click Review
Feedback from Evaluation
Responses
- The subcompetency will be displayed for your reference
- There are two areas of information:
1. Direct Evaluation Responses – Questionnaires can be configured to include the actual
milestone subcompetencies as questions on the evaluation forms. Responses to these
questions are considered Direct Evaluation Responses and will be available to the CCC in
the format shown below. The Line Graph shows the resident’s average score over time
(six month increments) and the Chart displays the number of responses given for each
level of the grade scale for that subcompetency. Note: Evaluation results will be
displayed in the month that corresponds with the end date of the match.
Click All to see the results from all direct milestone questions. Click Faculty to view just
the faculty members’ responses to the milestone questions. Click Non-faculty to view
the responses of nurses, residents and other non-faculty personnel on the milestone
questions.
2. Indirect Evaluation Responses – This area will display information gathered from
evaluations where standard questions have been mapped to Subcompetencies. Click
Expand to view the questions from the evaluations and the number of responses given for
each level of the grade scale. Check the box to ‘Include more general responses about
Patient Care’ to view other evaluation results that have not been specifically mapped to
a subcompetency, but are linked to a category
Milestone Reports
Once milestone reviews are complete, you can view milestone reports for individuals and for
your trainees as a group.
PEER AVERAGES REPORT
This spider graph displays the average scores for
residents on the competencies for each level of
training. This graph allows the program director
to visually see where the residents are exceeding
or lacking in progress in each competency and
make appropriate adjustments in the course of
study.
Go to Portfolio > Milestones and click on the
Peer Averages tab
Click Subcompetency Descriptions to view the
full text of the milestone subcompetencies
INDIVIDUAL PROGRESS
The Individual Progress graph displays the
competency level of a resident as they progress
through their years of training. The peer
average is also shown for each competency to
show how the resident rates against his/her
peers.
Go to Portfolio > Milestones and click on the
Personal Progress tab
Click Subcompetency Descriptions to view the
full text of the milestone subcompetencies
EVALUATION REPORTS
The results from direct
milestones on evaluations will
also be available on Evaluation
reports. The results of the
milestone questions will be
labeled with PC 1, MK 1, as
seen on the sample evaluation
report below. If you filter your
report to group the results by
Category or Core Competency,
the milestone results will
automatically be included in
the appropriate Category or
Core Competency.
RESIDENT/FELLOW VIEW
Residents and fellows can be allowed to see their own milestone reviews. They will see the
spider graph with their progress and they can click each completed year to view the form itself.
They cannot view comments or evaluations results.
1.
2.
3.
4.
Go to Portfolio > Milestones
Click the Gear icon in the top right corner of the Manage Milestones page
Check the box for Allow residents to view their own milestone progress
Click Save
ACCREDITATION
KEY METRICS – PROGRAM LEVEL
Milestones & Reviews
At the program level, graphs will be available to
display the results of the completed milestone
reviews. The spider graph below displays resident
competency in the milestones by year in training.
The ‘Residents being Reviewed’ widget shows how
many residents have milestone and semi-annual
reviews completed. The data is displayed for the
current and previous 6 month periods.
Go to Administration > Program to view the graph
for your program
When you click the ‘Residents being Reviewed’ panel, you can see more details including the
names of the residents in the program and their review status. The green check mark indicates a
milestone or semi-annual review has
been completed.
REVIEWS – GME LEVEL
At the GME level,
administrators will be able to
track how all of the programs
are progressing on their
Milestone Reviews and SemiAnnual Reviews. This report
displays the percentage of
residents in the accredited
programs who have had a
milestone review and a semiannual review completed.
Go to Administration > Sponsor > Reporting > Reviews
This handout is available on the InsideDFM web pages under Training Materials/New Innovations
or at this direct link:
https://inside.fammed.wisc.edu/sites/default/files/dmt/milestone-reviews.docx
A CBT of this information is also available on the InsideDFM web pages or at this direct link:
https://inside.fammed.wisc.edu/sites/default/files/dmt/milestone-reviews.mp4
For more information and to test your knowledge of Milestone Reviews, please take the Learning
Management System course available here:
http://uw.knowledgedirectweb.com
username: dfm.faculty@fammed.wisc.edu
password: dfm.faculty
Open the New Innovations Course and select NI Milestones